Provider Demographics
NPI:1770861593
Name:SNEAD, ELIZABETH GOUDREAU (PHARM D)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GOUDREAU
Last Name:SNEAD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 FORDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5912
Mailing Address - Country:US
Mailing Address - Phone:401-323-4011
Mailing Address - Fax:
Practice Address - Street 1:515 COLLEGE HWY STE 1
Practice Address - Street 2:
Practice Address - City:SOUTHWICK
Practice Address - State:MA
Practice Address - Zip Code:01077-9827
Practice Address - Country:US
Practice Address - Phone:413-569-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist